AI Article Synopsis

  • * Researchers analyzed data from the Optimum Patient Care Research Database, utilizing various modeling approaches, including logistic regression and XGBoost, to develop clinical prediction models.
  • * The XGBoost model showed promising accuracy in identifying undiagnosed small intestine NETs, suggesting that these models could aid in earlier identification, though further evaluation is needed to assess their effectiveness and cost-efficiency.

Article Abstract

Background: Neuroendocrine tumours (NETs) are increasing in incidence, often diagnosed at advanced stages, and individuals may experience years of diagnostic delay, particularly when arising from the small intestine (SI). Clinical prediction models could present novel opportunities for case finding in primary care.

Methods: An open cohort of adults (18+ years) contributing data to the Optimum Patient Care Research Database between 1st Jan 2000 and 30th March 2023 was identified. This database collects de-identified data from general practices in the UK. Model development approaches comprised logistic regression, penalised regression, and XGBoost. Performance (discrimination and calibration) was assessed using internal-external cross-validation. Decision analysis curves compared clinical utility.

Results: Of 11.7 million individuals, 382 had recorded SI NET diagnoses (0.003%). The XGBoost model had the highest AUC (0.869, 95% confidence interval [CI]: 0.841-0.898) but was mildly miscalibrated (slope 1.165, 95% CI: 1.088-1.243; calibration-in-the-large 0.010, 95% CI: -0.164 to 0.185). Clinical utility was similar across all models.

Discussion: Multivariable prediction models may have clinical utility in identifying individuals with undiagnosed SI NETs using information in their primary care records. Further evaluation including external validation and health economics modelling may identify cost-effective strategies for case finding for this uncommon tumour.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11263687PMC
http://dx.doi.org/10.1038/s41416-024-02736-1DOI Listing

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